Evidence map›Paper›PMID 30997125›Full record

ArticleOpen heart

Pregnancy complications and premature cardiovascular events among 1.6 million California pregnancies.

Rima Arnaout, Gregory Nah, Greg Marcus, Zian Tseng, Elyse Foster, Ian S Harris, Punag Divanji, Liviu Klein, Juan Gonzalez, Nisha Parikh

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open heart. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Rima ArnaoutDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Gregory NahDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Greg MarcusDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Zian TsengDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Elyse FosterDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Ian S HarrisDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Punag DivanjiDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Liviu KleinDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Juan GonzalezDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
Nisha ParikhDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
University of California, San Francisco · US

Funding

Unsolicited R24 for the CFAR-Network of Integrated Clinical Sciences, CNICSR24AI067039 · NIAID · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Michael S. Saag · 2006 to 2026
$99.4M
Cardiac Pathology and Risk Prediction for Sudden Cardiac Death in Patients with HIVR01HL126555 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TSENG, ZIAN H · 2014 to 2017
$3.1M
Comprehensive autopsy characterization of sudden cardiac deathR01HL102090 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TSENG, ZIAN H · 2010 to 2014
$2.8M
Genetics and Structure of Trabecular Myocardium in Development and DiseaseK08HL125945 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ARNAOUT, RIMA · 2015 to 2019
$863k
Pregnancy complications, future cardiovascular disease risk factors and cardiovasR21HL115398 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PARIKH, NISHA INDRAVADAN · 2013 to 2014
$446k
NHLBI NIH HHS K08 HL125945NHLBI NIH HHS R01 HL102090NHLBI NIH HHS R01 HL126555NHLBI NIH HHS R21 HL115398NIAID NIH HHS R24 AI067039
6 · The paper itself

Abstract

Background: Cardiovascular complications of pregnancy present an opportunity to assess risk for subsequent cardiovascular disease. We sought to determine whether peripartum cardiomyopathy and hypertensive disorder of pregnancy subtypes predict future myocardial infarction, heart failure or stroke independent of one another and of other risks such as gestational diabetes, preterm birth and intrauterine growth restriction. Methods and results: The California Healthcare Cost and Utilization Project database was used to identify all hospitalised pregnancies from 2005 to 2009, with follow-up through 2011, for a retrospective cohort study. Pregnancies, exposures, covariates and outcomes were defined by International Classification of Diseases, Ninth Revision codes. Among 1.6 million pregnancies (mean age 28 years; median follow-up time to event excluding censoring 2.7 years), 558 cases of peripartum cardiomyopathy, 123 603 hypertensive disorders of pregnancy, 107 636 cases of gestational diabetes, 116 768 preterm births and 23 504 cases of intrauterine growth restriction were observed. Using multivariable Cox proportional hazards models, peripartum cardiomyopathy was independently associated with a 39.2-fold increase in heart failure (95% CI 30.0 to 51.9), resulting in ~1 additional hospitalisation per 1000 person-years. There was a 13.0-fold increase in myocardial infarction (95% CI 4.1 to 40.9) and a 7.7-fold increase in stroke (95% CI 2.4 to 24.0). Hypertensive disorders of pregnancy were associated with 1.4-fold (95% CI 1.0 to 2.0) to 7.6-fold (95% CI 5.4 to 10.7) higher risk of myocardial infarction, heart failure and stroke, resulting in a maximum of ~1 additional event per 1000 person-years. Gestational diabetes, preterm birth and intrauterine growth restriction had more modest associations. Conclusion: These findings support close monitoring of women with cardiovascular pregnancy complications for prevention of early cardiovascular events and study of mechanisms underlying their development.

Indexed as

cardiovascular diseasehypertensive disorders of pregnancyperipartum cardiomyopathywomen

Identifiers

PMID30997125
PMCPMC6443129
OpenAlexW2919092603

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.